The Truth About Cutting: Why Stressed-Out Girls Are Taking Dangerous Measures to Cope

Teen Vogue investigates self-harm's stranglehold.

To say that 17-year-old Audrey* has a crazy schedule would be a major understatement. "I'm in student council, head of the Spanish club, and on the varsity lacrosse and golf teams," the high school junior states. "I also take two AP classes and two honors courses. I'm pretty social, too, so I have to balance the things I need to do with the things I want to do." Because Audrey seems to have it so together, friends even come to her for advice. "I put a lot of pressure on myself to live up to their assumptions," she says.

The constant stress of high expectations brought Audrey to a breaking point last May, when the possibility of failing her chemistry class felt like too much to handle on top of everything else. "That was the first time I cut myself," she confides. "It was an outward sign of how stressed I felt; it wasn't just in my head anymore."

Audrey isn't alone in feeling overwhelmed—27 percent of teens admitted to being extremely stressed during the past school year, according to a 2014 report from the American Psychological Association—and, scarier yet, she's not alone in how she's chosen to cope. A recent study from King's College London shows that one in 12 teens reported having self-harmed, and that more of them are girls.

Why is such destructive behavior so widespread? According to Allison Kress, Psy.D., a clinical psychologist in California who specializes in cutting, it takes hold because "girls can secretly cope while still seeming like they're OK to everyone else." The problem with cutting as an emotional outlet is that it's just a quick fix—and a dangerous one at that. "It distracts you from what you're feeling, but it doesn't actually confront the deeper problems you're dealing with," Dr. Kress says, adding that many of her patients are exactly the kinds of girls you wouldn't expect: the valedictorians and star athletes, the well-rounded high achievers whose lives seem picture-perfect.

For 14-year-old eighth grader Carly*, there are few things more stressful than change. And between switching middle schools last year and trying to get into private high schools this year, her whole world feels different. "Everything became so overwhelming that it pushed me over the edge," she says of the first time she decided to cut herself a year ago. Eventually, Carly started self-harming every day. "I was sick of feeling that pain and stress in my head," she says. "When I felt physical pain, it took that away. I knew it wasn't a good thing, but I thought the stress I was feeling was worse."

The road to cutting is often like Carly's: It's less about a specific desire to do harm than it is about desperation for some kind of outlet. With situations of high stress, "teens aren't explicitly taught how to cope," says Nancy Rappaport, M.D., an associate professor of psychiatry at Harvard Medical School. "The key is noticing changes in your body so you can recognize the signs. If you start biting your nails or picking your eyebrows, that's a signal to look for alternative ways to manage your emotions before you get to a point where you might want to self-harm."

College senior Amy, 22, has struggled with crippling stress—and the resulting urge to cut herself—since eighth grade, especially with the pressure of having a "supersmart" older sister. "I was always compared to her, and if I didn't get the grades she did, I'd get yelled at when I got home," she says. Amy thought cutting was the only way to get through it. "Between the stress at school and the stress from my family, if a problem came up, I would take it out on myself. When people saw the scars, I'd tell them I fell, or that a dog scratched me, or that it was a sports thing. I never really knew how to say, 'There's something wrong, this is what's going on, what do I do?'" she admits. "I had no sense of control in my life, but cutting made me feel in control of something." Over time Amy came to learn that the control she felt was both fleeting and false. According to Dr. Kress, cutting "only creates more problems. You have the initial thoughts and feelings that make you do it, and then the stress of dealing with what you've just done to yourself. That spirals into more stress, lower self-esteem, depression, and isolation. Then you have to ask yourself, Who's really in control: Cutting or me?"

When it all got to be too much for Carly, she confided in a close friend, who immediately told their school's guidance counselor. Opening up about stress and self-harm can be scary, and may feel as if you're admitting a weakness or a failure—which is especially hard for people who want to seem like they're totally on top of things. But "cutting thrives on secrecy and fear, so the most important way to get help is to share what you're doing with someone you trust," Dr. Kress advises. "In fact, stepping up and taking care of it shows your strength."

Cutting to cope is not the answer, and it never will be. Says Amy, "It's kind of like putting on a bandage when you really need stitches. In the end, you have a scar, not a solution."

*Name has been changed

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